Butterworth James, Deguara Jean, Borg Cynthia-Michelle
University Hospital Lewisham, Lewisham and Greenwich NHS Trust, London, UK.
Kingston Hospital NHS Foundation Trust, Kingston upon Thames, UK.
J Obes. 2016;2016:1871594. doi: 10.1155/2016/1871594. Epub 2016 Nov 14.
Polycystic ovary syndrome (PCOS) is the commonest cause of female infertility. Visceral obesity and insulin resistance are key pathophysiological mechanisms behind PCOS. Women suffering from this syndrome and infertility often seek bariatric surgery hoping that they would be able to conceive postoperatively. At present, there is no consensus on the role of bariatric surgery in the management of PCOS-associated infertility within the medical community, making it difficult to give specific advice to these women, so a review of the literature was necessary. A detailed review of the literature was performed. Only 6 manuscripts were relevant and contained quantitative data. They demonstrated that bariatric surgery results in postoperative conception rates varying from 33% to 100%. Surgery is also associated with amelioration of menstrual irregularities, hormonal abnormalities, and hirsutism that are associated with PCOS. These studies were retrospective and only had a small number of participants with infertility. Bariatric surgery has been shown to conclusively improve life expectancy, quality of life, and comorbidities like type 2 diabetes and obstructive sleep apnea. However, further research is required to identify whether weight loss surgery results in significant improvement in fertility of women with PCOS and to investigate which operation has the best results.
多囊卵巢综合征（PCOS）是女性不孕最常见的原因。内脏肥胖和胰岛素抵抗是PCOS背后的关键病理生理机制。患有这种综合征和不孕症的女性常常寻求减肥手术，希望术后能够受孕。目前，医学界对于减肥手术在治疗PCOS相关不孕症中的作用尚无共识，难以向这些女性提供具体建议，因此有必要对文献进行综述。我们对文献进行了详细综述。仅有6篇手稿相关且包含定量数据。这些数据表明，减肥手术的术后受孕率在33%至100%之间。手术还与改善PCOS相关的月经不调、激素异常和多毛症有关。这些研究均为回顾性研究，且参与不孕症研究的受试者数量较少。减肥手术已被证明能切实提高预期寿命、生活质量，并改善2型糖尿病和阻塞性睡眠呼吸暂停等合并症。然而，需要进一步研究来确定减肥手术是否能显著改善PCOS女性的生育能力，并探究哪种手术效果最佳。
